Emmanuel Eduardo Elizondo
Individual provider Active NPI Administrator Registered Nurse · Zapata, TX
NPI 1750162921 · NPPES record last updated Oct 12, 2023
Key facts
- NPI
- 1750162921
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Administrator Registered Nurse 163WA2000X
- License
- 856927 (TX)
- Practice address
- 124 S US Highway 83 Unit 8
Zapata, TX 78076-3813 - Phone
- (956) 750-6592
- NPI assigned
- Oct 12, 2023
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 856927 | TX | MD | Administrator Registered Nurse |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Divine Health Services LLC | Current |
Accepting new patients |
Locations
124 S US Highway 83
Ste 8
Zapata, TX 78076
Phone (956) 750-6592
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Administrator Registered Nurse | 163WA2000X | 856927 | TX | Yes |
Addresses
Primary practice location
124 S US Highway 83 Unit 8
Zapata, TX 78076-3813
Mailing address
124 S US Highway 83 Unit 8
Zapata, TX 78076-3813
Phone (956) 750-6592
Other providers in Zapata, TX
- Daniel'S Pharmacy Inc
- Daria Babineaux MD PA
- Del Mar Primary Home Care, LLC.
- Divine Health Services LLC
- El Parque Adult Day Care Inc
- Falcon Lake Health Care, LTD
- Falcon Lake Health Care, LTD.
- Falcon Lake Nursing Home, LLC
- Fortaleza Home Care, LLC
- Kaitlyn M Garcia
All providers in Zapata, TX · Administrator Registered Nurse in Texas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 12, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.